CAJ | 학술논문

目的：探讨尿动力学检查在女性膀胱出口梗阻（ FBOO）的诊治及尿动力学检查的应用价值。方法收集32例疑似FBOO的患者，年龄21～80岁，平均56．3岁。主诉有尿频、尿急、排尿困难等下尿路症状，对患者完善常规检查，同期行膀胱镜、排尿期尿道造影以及尿动力学检查。对确诊为解剖性FBOO的患者行经尿道膀胱颈切开术，术后3个月进行随访比较。结果32例疑似FBOO患者中解剖性FBOO20例，功能性FBOO7例，正常5例。解剖性FBOO组与功能性FBOO组比较尿动力指标，其中最大尿流率、峰值尿流率膀胱逼尿肌压力、最大逼尿肌压力、最大尿道闭合压差异均有显著性意义（ P＜0．05）。对20例解剖性FBOO患者行经尿道膀胱颈切开术，术后3个月进行随访。术前和术后比较，最大尿流率、峰值尿流率膀胱逼尿肌压力、最大逼尿肌压力、最大尿道闭合压、残余尿量差异均有显著性意义（P＜0．05）。结论尿动力学检查可对功能性与解剖性的女性膀胱出口梗阻作出客观判断。经尿道离子束刀膀胱颈切开术治疗解剖性FB00疗效安全、恢复快、并发症少。尿动力学检查在女性膀胱出口梗阻术后评价方面具有重要价值。
목적：탐토뇨동역학검사재녀성방광출구경조（ FBOO）적진치급뇨동역학검사적응용개치。방법수집32례의사FBOO적환자，년령21～80세，평균56．3세。주소유뇨빈、뇨급、배뇨곤난등하뇨로증상，대환자완선상규검사，동기행방광경、배뇨기뇨도조영이급뇨동역학검사。대학진위해부성FBOO적환자행경뇨도방광경절개술，술후3개월진행수방비교。결과32례의사FBOO환자중해부성FBOO20례，공능성FBOO7례，정상5례。해부성FBOO조여공능성FBOO조비교뇨동력지표，기중최대뇨류솔、봉치뇨류솔방광핍뇨기압력、최대핍뇨기압력、최대뇨도폐합압차이균유현저성의의（ P＜0．05）。대20예해부성FBOO환자행경뇨도방광경절개술，술후3개월진행수방。술전화술후비교，최대뇨류솔、봉치뇨류솔방광핍뇨기압력、최대핍뇨기압력、최대뇨도폐합압、잔여뇨량차이균유현저성의의（P＜0．05）。결론뇨동역학검사가대공능성여해부성적녀성방광출구경조작출객관판단。경뇨도리자속도방광경절개술치료해부성FB00료효안전、회복쾌、병발증소。뇨동역학검사재녀성방광출구경조술후평개방면구유중요개치。
Objective To investigate the urodynamic changes of female bladder outlet obstruction ( FBOO) and the clinical diagnosis and prognosis value of urodynamic examination.Methods Thirty-two female outpatients with mean age of 56.3 (21 to 80 years) were suspecious with FBOO according to their clinical presentations.Their chief complaints included low urinary tract symptoms such as frequent micturition,urgent urination and dysuria.All patients received cystoscopy and cys-tourethrography examination.Urodynamic examination was also performed in all patients.Patients with confirmed diagnosis of anatomical FBOO received Transurethral Resection of Bladder Neck.Urinary ultrasonography and dynamic examination were performed and compared again after 3 months of the operation.Results Twenty cases were confirmed with diagnosis of anatomical FBOO,7 cases with functional FBOO, and 5 normal cases.Compared to functional FBOO group, anatomical FBOO group showed significant urodynamic changes including Qmax,Pdet.Qmax,Pdet.max and MUCP (P<0.05).For the 20 cases received operation,significant differences were seen in Qmax,Pdet.Qmax,Pdet.max,MUCP and RV before and after operation (P<0.05).Conclusions The confirmed diagnosis of functional bladder and obstructive disease of the bladder neck could be made by urodynamic examination.It's safe and efficient and has fewer complications in TURBN. Urodynamic examination plays an important role in the follow-up of female FBOO patients.